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Khan M.M.H.,Bielefeld University | Kramer A.,Bielefeld University | Khandoker A.,Bielefeld University | Prufer-Kramer L.,Travel Clinic | Islam A.,International Center for Diarrheal Disease Research Bangladesh
Bulletin of the World Health Organization | Year: 2011

Objective To assess levels, trends and gaps between the poorest and the richest in selected health and human development indicators in Bangladesh. Methods Data for selected indicators associated with sociodemographic characteristics among ever-married women, contraception use, child vaccination, antenatal care practices and health conditions were extracted from the Bangladesh Demographic and Health Surveys conducted in 1993-94, 1996-1997, 1999-2000, 2004 and 2007. Results for the whole sample and for the poorest and the richest wealth quintiles are presented. Findings Positive trends were noted in urbanization, availability of electricity, age at first marriage, use of modern contraception, access to skilled antenatal care, child vaccination, knowledge of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome and overweight and obesity. In contrast, negative trends were seen in factors such as literacy, infant and child mortality, fertility rate, home delivery and malnutrition and underweight. However, changes in these indicators differed between the poorest and richest quintiles. For instance, only the richest quintile experienced rapid urbanization, whereas illiteracy declined more among the poorest. Noteworthy gaps were found in almost all factors. Rich-poor gaps in urbanization, age at marriage, fertility, condom use, home delivery and overweight increased; in contrast, gaps in education, water and sanitation, use of contraception (except condoms) and child vaccination declined. Conclusion Persistent inequities in Bangladesh endanger equitable and sustainable human development in the country. Pro-poor development strategies based on the principles of equity and quality should be implemented to narrow existing gaps and further promote holistic and equitable human development. Source


Haque U.,International Center for Diarrheal Disease Research Bangladesh | Haque U.,Norwegian University of Life Sciences | Haque U.,Nagasaki University | Scott L.M.,Esri | And 4 more authors.
Malaria Journal | Year: 2012

Background: Malaria treatment-seeking practices vary worldwide and Bangladesh is no exception. Individuals from 88 villages in Rajasthali were asked about their treatment-seeking practices. A portion of these households preferred malaria treatment from the National Control Programme, but still a large number of households continued to use drug vendors and approximately one fourth of the individuals surveyed relied exclusively on non-control programme treatments. The risks of low-control programme usage include incomplete malaria treatment, possible misuse of anti-malarial drugs, and an increased potential for drug resistance. Methods. The spatial patterns of treatment-seeking practices were first examined using hot-spot analysis (Local Getis-Ord Gi statistic) and then modelled using regression. Ordinary least squares (OLS) regression identified key factors explaining more than 80% of the variation in control programme and vendor treatment preferences. Geographically weighted regression (GWR) was then used to assess where each factor was a strong predictor of treatment-seeking preferences. Results: Several factors including tribal affiliation, housing materials, household densities, education levels, and proximity to the regional urban centre, were found to be effective predictors of malaria treatment-seeking preferences. The predictive strength of each of these factors, however, varied across the study area. While education, for example, was a strong predictor in some villages, it was less important for predicting treatment-seeking outcomes in other villages. Conclusion: Understanding where each factor is a strong predictor of treatment-seeking outcomes may help in planning targeted interventions aimed at increasing control programme usage. Suggested strategies include providing additional training for the Building Resources across Communities (BRAC) health workers, implementing educational programmes, and addressing economic factors. © 2012 Haque et al; licensee BioMed Central Ltd. Source


Pierce B.L.,University of Chicago | Tong L.,University of Chicago | Argos M.,University of Chicago | Gao J.,University of Chicago | And 21 more authors.
International Journal of Epidemiology | Year: 2013

Background Arsenic exposure through drinking water is a serious global health issue. Observational studies suggest that individuals who metabolize arsenic efficiently are at lower risk for toxicities such as arsenical skin lesions. Using two single nucleotide polymorphisms (SNPs) in the 10q24.32 region (near AS3MT) that show independent associations with metabolism efficiency, Mendelian randomization can be used to assess whether the association between metabolism efficiency and skin lesions is likely to be causal.Methods Using data on 2060 arsenic-exposed Bangladeshi individuals, we estimated associations for two 10q24.32 SNPs with relative concentrations of three urinary arsenic species (representing metabolism efficiency): inorganic arsenic (iAs), monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA). SNP-based predictions of iAs%, MMA% and DMA% were tested for association with skin lesion status among 2483 cases and 2857 controls.Results Causal odds ratios for skin lesions were 0.90 (95% confidence interval [CI]: 0.87, 0.95), 1.19 (CI: 1.10, 1.28) and 1.23 (CI: 1.12, 1.36) for a one standard deviation increase in DMA%, MMA% and iAs%, respectively. We demonstrated genotype-arsenic interaction, with metabolism-related variants showing stronger associations with skin lesion risk among individuals with high arsenic exposure (synergy index: 1.37; CI: 1.11, 1.62).Conclusions We provide strong evidence for a causal relationship between arsenic metabolism efficiency and skin lesion risk. Mendelian randomization can be used to assess the causal role of arsenic exposure and metabolism in a wide array of health conditions. Developing interventions that increase arsenic metabolism efficiency are likely to reduce the impact of arsenic exposure on health. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2013; all rights reserved. Source


Zahirul Haq M.,International Center for Diarrheal Disease Research Bangladesh | Alam M.S.,International Center for Diarrheal Disease Research Bangladesh | Haque U.,University of Florida
ISPRS International Journal of Geo-Information | Year: 2015

Bangladesh is a malaria endemic country. There are 13 districts in the country bordering India and Myanmar that are at risk of malaria. The majority of malaria morbidity and mortality cases are in the Chittagong Hill Tracts, the mountainous southeastern region of Bangladesh. In recent years, malaria burden has declined in the country. In this study, we reviewed and summarized published data (through 2014) on the use of geospatial technologies on malaria epidemiology in Bangladesh and outlined potential contributions of geospatial technologies for eliminating malaria in the country. We completed a literature review using "malaria, Bangladesh" search terms and found 218 articles published in peer-reviewed journals listed in PubMed. After a detailed review, 201 articles were excluded because they did not meet our inclusion criteria, 17 articles were selected for final evaluation. Published studies indicated geospatial technologies tools (Geographic Information System, Global Positioning System, and Remote Sensing) were used to determine vector-breeding sites, land cover classification, accessibility to health facility, treatment seeking behaviors, and risk mapping at the household, regional, and national levels in Bangladesh. To achieve the goal of malaria elimination in Bangladesh, we concluded that further research using geospatial technologies should be integrated into the country's ongoing surveillance system to identify and better assess progress towards malaria elimination. Source


Stockman L.J.,Centers for Disease Control and Prevention | Brooks W.A.,International Center for Diarrheal Disease Research Bangladesh | Streatfield P.K.,International Center for Diarrheal Disease Research Bangladesh | Rahman M.,International Center for Diarrheal Disease Research Bangladesh | And 5 more authors.
PLoS ONE | Year: 2013

Background: Acute lower respiratory illness is the most common cause of death among children, globally. Data are not available to make accurate estimates on the global mortality from respiratory syncytial virus (RSV), specifically. Methods: Respiratory samples collected from children under 5 years of age during 2004 to 2008 as part of population-based respiratory disease surveillance in an urban community in Dhaka, Bangladesh were tested for RSV, human metapneumovirus (HMPV), human parainfluenza virus (PIV) types 1, 2, and 3, influenza and adenovirus by RT-PCR. Verbal autopsy data were used to identify children who died from respiratory illness in a nearby rural community. Significance of the correlation between detections and community respiratory deaths was determined using Spearman's coefficient. Results: RSV activity occurred during defined periods lasting approximately three months but with no clear seasonal pattern. There was no significant correlation between respiratory deaths and detection of any of the respiratory viruses studied. Conclusion: Outbreaks of respiratory viruses may not be associated with deaths in children in the study site; however, the few respiratory deaths observed and community-to-community variation in the timing of outbreaks may have obscured an association. An accurate assessment of respiratory virus-associated deaths will require detections and death data to come from the same location and a larger study population. Source

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